Risk Factors for Premature Myocardial Infarction: A Systematic Review and Meta-analysis of 77 Studies

• Published in: Mayo Clinic proceedings. Innovations, quality & outcomes quality & outcomes, 2021-08, Vol.5 (4), p.783-794
• Main Authors: Dugani, Sagar B., Hydoub, Yousif M., Ayala, Ana Patricia, Reka, Roger, Nayfeh, Tarek, Ding, Jingyi (Francess), McCafferty, Shannon N., Alzuabi, Muayad, Farwati, Medhat, Murad, M. Hassan, Alsheikh-Ali, Alawi A., Mora, Samia
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2542-4548; 2542-4548
• DOI: 10.1016/j.mayocpiqo.2021.03.009

To evaluate the magnitude of the association between risk factors and premature myocardial infarction (MI) (men aged 18-55 years; women aged 18-65 years). We searched MEDLINE and other databases from inception through April 30, 2020, as well as bibliography of articles selected for data extraction. We selected observational studies reporting the magnitude of the association of at least 1 risk factor (demographic characteristics, lifestyle factors, clinical risk factors, or biomarkers) with premature MI and a control group. Pooled risk estimates (random effects) from all studies unadjusted and adjusted for risk factors were reported as summary odds ratios (ORs) with 95% CIs. From 35,320 articles, we extracted data on 19 risk factors in 12.7 million participants from 77 studies across 58 countries. Men had a higher risk of premature MI (OR, 2.39; 95% CI, 1.71 to 3.35) than did women. Family history of cardiac disease was associated with a higher risk of premature MI (OR, 2.67; 95% CI, 2.29 to 3.27). Major modifiable risk factors associated with higher risk were current smoking (OR, 4.34; 95% CI, 3.68 to 5.12 vs no/former), diabetes mellitus (OR, 3.54; 95% CI, 2.69 to 4.65), dyslipidemia (OR, 2.94; 95% CI, 1.76 to 4.91), and hypertension (OR, 2.85; 95% CI, 2.48 to 3.27). Higher body mass index carried higher risk (OR, 1.46; 95% CI, 1.24 to 1.71 for ≥25 kg/m2 vs